Cognitive outcomes and health-related quality of life in adults two decades after the arterial switch operation for transposition of the great arteries

Kalfa, David; Kasmi, L.; Geronikola, Nikoletta; Calderon, Johanna; Lambert, Virginie; Belli, Emrè; Bonnet, Damien; Montreuil, Michèle

doi:10.1016/j.jtcvs.2017.03.119

Cited by 16 publications

(11 citation statements)

References 29 publications

(29 reference statements)

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“… No statistically significant difference in the mean SF6D scores between ASO patients and the general Australian population (18–24 age group: [0.769 for ASO patients vs 0.772 for Australian population, P = 0.85]; 25–34 age group [0.795 for ASO patients vs 0.780 for Australian population, P = 0.33]). Kalfa et al [ 33 ]: Evaluated the cognitive and psychological outcomes of 67 ASO adults (18.0–31.0 years) compared to 43 matched controls using the Short Form 36 (SF-36). ASO patients had a statistically significant lower physical component summary compared to controls (52.1 ± 7.5 vs 55.4 ± 5.9, P = 0.01).…”

Section: Resultsmentioning

confidence: 99%

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Outcomes after corrective surgery for congenital dextro-transposition of the arteries using the arterial switch technique: a scoping systematic review

et al. 2020

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Background Dextro-transposition of the great arteries (d-TGA) is the most frequent cyanotic congenital heart pathology in neonates. Surgical correction of this condition is possible using the arterial switch operation (ASO) which was first performed by Jatene in 1975. Objectives The aim of this study was to summarise the evidence on short- (less than 1 year), medium- (1–20 years), and long-term (more than 20 years) outcomes of children with d-TGA treated with the ASO. The primary outcome was survival. Secondary outcomes were freedom from cardiac reoperations, occurrence of aortic insufficiency, pulmonary stenosis, coronary artery anomalies, neuropsychological development problems and quality of life. Methods We searched MEDLINE, EMBASE, CINAHL, LILACS, and reference lists of included articles for studies reporting outcomes after ASO for d-TGA. Screening, data extraction and risk of bias assessment were done independently by two reviewers. We pooled data using a random-effects meta-analysis of proportions and, where not possible, outcomes were synthesized narratively. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to assess the certainty of the evidence for each outcome. Main results Following ASO for TGA, short-term survival was 92.0% (95% CI 91.0–93.0%; I2 = 85.8%, 151 studies, 30,186 participants; moderate certainty evidence). Medium-term survival was 90.0% (95% CI 89.0–91.0%; I2 = 84.3%, 133 studies; 23,686 participants, moderate certainty evidence), while long-term survival was 87.0% (95% CI 80.0–92.0 %; I2 = 84.5%, 4 studies, 933 participants, very low certainty evidence). Evaluation of the different secondary outcomes also showed satisfactory results in the short, medium and long term. Subgroup analysis suggests slightly higher survival following ASO for TGA in the second surgical era (1998 to 2018) than in the first surgical era (1975 to 1997) in the short and medium term [93.0% (95% CI 92.0–94.0) vs 90.0% (95% CI 89.0–92.0) and 93.0% (95% CI 91.0–94.0) vs 88.0% (87.0–90.0%) respectively] but not in the long term [81.0% (95% CI 76.0–86.0%) vs 89.0% (80.0–95.0%)]. Conclusions Pooled data from many sources suggests that the ASO for d-TGA leads to high rates of survival in the short, medium, and long term.

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Section: Resultsmentioning

confidence: 99%

“…Seven studies evaluated the quality of life of ASO survivors [32][33][34][35][36][37][38]. They used different scales and reported on different aspects, hence a meta-analysis of the results was not possible, and the results were narratively summarised (see Table 2).…”

Section: Quality Of Life Outcomesmentioning

confidence: 99%

Outcomes after corrective surgery for congenital dextro-transposition of the arteries using the arterial switch technique: a scoping systematic review

et al. 2020

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“…The lifetime prevalence for anxiety and depressive disorders was 54 and 43%, respectively, reflecting a highly significant increase compared with the control group. In contrast, the same group reported no increase of depression or anxiety in adult patients with TGA after ASO if the current and not the life-time prevalence was evaluated for example using the HADS questionnaire ( 25 , 26 ). These findings underline the need for repetitive testing for psychiatric distress in adults with congenital heart disease.…”

Section: Discussionmentioning

confidence: 93%

Anxiety and Depression in Adults With Congenital Heart Disease

et al. 2022

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IntroductionAnxiety and depression can worsen outcome in patients with heart disease. We elucidate the prevalence of anxiety and depression in a cohort of adults with congenital heart disease (ACHD).Materials and MethodsProspective screening for anxiety or depression was performed in 204 consecutive patients of the outpatient clinic of our tertiary care center using the Hospital Anxiety and Depression Scale (HADS) questionnaire and the distress thermometer (DT) as a potential ultra-short screening test. Functional data were assessed at liberty of the responsible physician. HADS scores ≥ 8 were considered doubtful and scores ≥ 11 as confirmed cases of anxiety or depression, respectively. HADS results were compared with a historical group of 100 patients with non-Hodgkin Lymphoma (NHL) as well as German reference values from the literature.ResultsPatients from the ACHD cohort were 28 ± 10 years old (mean ± SD, 54% male), 34% had a simple, 51% a moderate, including 52 patients with transposition of the great arteries after arterial switch operation, and 15% a heart defect of severe complexity. Prevalence of depression in ACHD was comparable to the German normal population (5.9% ACHD vs. 5.4% control). In contrast, prevalence of anxiety was higher than expected from reference values (12.7% ACHD vs. 5.6% control). There was a positive association between psychological distress and NYHA class [anxiety: OR 2.67 (95% CI, 1.50–4.76) p = 0.001; depression: OR 2.93 (95% CI, 1.60–5.35) p = 0.0005], but not with age, gender, or heart defect severity. Percentages of patients with ACHD with anxiety were significantly higher than in a cohort of patients with indolent non-Hodgkin lymphoma (NHL) but comparable to those with aggressive NHL (HADS-A ≥ 11: ACHD 12.7%, indolent NHL 2.2%, aggressive NHL 13.2%; p = 0.037 ACHD vs. indolent NHL; p = 0.929 ACHD vs. aggressive NHL). The distress thermometer screening test had only a fair discriminatory ability (AUC 0.708; p = 0.002) and is therefore of limited usability.ConclusionAdults with congenital heart disease exhibit an increased risk for anxiety disorders independently of the severity of the underlying heart defect. Anxiety prevalence was comparable to a historical cohort of patients with aggressive NHL underlining the importance of a routine screening for psychosocial distress in adults with congenital heart disease.

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“…Our results suggested that quality of life in ASO survivors is similar to that of the general population. Likewise, this topic was recently addressed by Kalfa and colleagues [37], who investigated cognitive and quality-of-life outcomes in 67 adult ASO survivors 18 to 31 years of age. In their study, despite patients reporting an overall satisfying quality of life, cognitive difficulties and impairments occurred in 31% of survivors compared with 16% in the general population.…”

Section: Long-term Cognitive Outcomes and Quality Of Life After Asomentioning

confidence: 98%

Arterial Switch Operation: Operative Approach and Outcomes

Fricke

Konstantinov

2019

The Annals of Thoracic Surgery

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Cognitive outcomes and health-related quality of life in adults two decades after the arterial switch operation for transposition of the great arteries

Cited by 16 publications

References 29 publications

Outcomes after corrective surgery for congenital dextro-transposition of the arteries using the arterial switch technique: a scoping systematic review

Outcomes after corrective surgery for congenital dextro-transposition of the arteries using the arterial switch technique: a scoping systematic review

Anxiety and Depression in Adults With Congenital Heart Disease

Arterial Switch Operation: Operative Approach and Outcomes

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